CANCER INCIDENCE IN A COHORT OF HUMAN-IMMUNODEFICIENCY-VIRUS SEROCONVERTERS

BACKGROUND. In addition to Kaposi's sarcoma and non-Hodgkin's lymphoma s, it has been postulated that human immunodeficiency virus (HIV) infe ction may increase the risk of other cancers. The aim of the current s tudy was to compare incidence rates of cancer among individuals who se roconverted for HIV infection wit the rates in the general population of Italy. METHODS. This study is part of an ongoing cohort investigati on conducted bu the HIV Italian Seroconversion Study Group. The study has enrolled 1255 individuals (906 males and 349 females) between the ages of 20 and 49 years who are at risk for HIV infection and have had a documented negative HIV test followed by a positive rest. For each individual, the midpoint in time between the negative and positive tes ts was used to estimate the seroconversion date. The person-years at r isk for cancer were then computed from the midpoint date to the last f ollow-up date or to death, and the number of cases of cancer observed in the cohort was compared with the expected number, based on rates am ong the general population of the same age and gender. Standardized in cidence ratios (SIR) and 95% confidence intervals (CI) were computed. RESULTS. A total of 58 cases of cancer were observed in the cohort. In comparison with rates in the general population, Kaposi's sarcoma was 1051 times more frequent, and non-Hodgkin's lymphomas were 157 times more frequent. Hodgkin's disease was observed in 3 men (i.e., 38 times more often in the cohort of HIV seroconverters [95% CI, 8-111]), in p articular among homosexual men (SIR = 103). One woman developed stomac h carcinoma. CONCLUSIONS. The findings of the current incidence study are in agreement with previous studies showing excesses of Kaposi's sa rcoma and non-Hodgkin's lymphomas in HIV-positive individuals. In addi tion, the findings suggest an association of HIV infection with Hodgki n's disease. Whether Hodgkin's disease in HIV-infected individuals sho uld be considered an AIDS-defining illness is a question that is worth y of attention. (C) 1997 American Cancer Society.